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in order to prevent the spread of infection, and in 19 cases compensation was
authorised. The total sum paid in compensation was £91 6s. 1Od.
Uncertified
persons.
The Midwives and Maternity Homes Act, 1926, amended section 1 (2) of the
Midwives Act, 1902, so as to make it an offence for any uncertified person to attend
women in childbirth, except under the direction and personal supervision of a
registered medical practitioner, unless the case was one of sudden or urgent necessity.
During the year 9 enquiries were made into alleged infringements of this law, compared
with 16 in 1929. Two women were prosecuted, one being fined £5 and the
other £4. In 3 cases no further action was taken ; in 4 a caution was administered.
Still-births.
The Births and Deaths Registration Act, 1926, requires that the birth of every
still-born child shall be registered by the registrar in a register of still-births, containing
the heads of information prescribed by the first schedule of the Act. During
the year there were 408 still-births reported by midwives in their practice, compared
with 582 in 1923, 594 in 1924, 510 in 1925, 513 in 1926, 486 in 1927, 473 in 1928
and 413 in 1929. Of the cases reported this year 239 were male and 169 female;
233 were reported as macerated, 172 not macerated, and in 3 the condition was
not stated.
Puerperal
fever.
During the year 284 cases of puerperal fever were investigated, compared with
311 in 1929. Of these cases 62 proved fatal, the same number as in 1929, a case
mortality of 21.8 per cent., compared with 19.9 per cent. in 1929. In addition, the
Council was informed of 29 deaths from puerperal sepsis which were not notified as
"puerperal fever," compared with 39 the previous year. The distribution of the 284
cases, with the mode of delivery, was as follows, deaths being shown in brackets:—
Medical practitioners 88 (19); certified midwives 62 (11); medical practitioner
and certified midwife 4 (0); hospitals and poor law institutions 72 (12); medical
students 8 (4); cases of miscarriage or abortion where no attendant was engaged
44 (15); uncertified women 1 (0); not ascertained 5 (1). Total, 284 (62).
Puerperal
pyrexia.
In July, 1926, the Ministry of Health made regulations requiring the notification
of puerperal pyrexia, which is defined by the regulations to be "any febrile condition
(other than a condition which is required to be notified as puerperal fever under
the Infectious Diseases (Notification) Acts) occurring in a woman within 21 days
after child-birth or miscarriage in which a temperature of 100.4° Fahrenheit (38°
Centigrade) or more has been sustained during a period of 24 hours or has recurred
during that period."
The regulations were amended in 1928 and now require a medical practitioner
to notify any such case on the approved form and transmit the notification to the
medical officer of health of the district in which the patient is actually living at
the time of notification. Any notification of a case in a London hospital must specify
the place from which and the date at which the patient was brought to the hospital
and must be sent to the medical officer of health of the district in which the said
place is situated; 760 notifications of puerperal pyrexia were received during 1930,
compared with 781 in 1929, and 52 cases proved fatal. Particulars of the attendant
at the confinement are set out here, the deaths being shown in brackets:—Medical
practitioners 150(11); certified midwives 154 (16); medical practitioner and certified
midwife 2 (0); hospitals and poor law institutions 367 (21); medical students 25 (0);
cases of miscarriage or abortion where no attendant was engaged 58 (4); no information
4 (0). Total, 760 (52). Twenty-eight of the cases, with 11 deaths, were
subsequently notified as puerperal fever, and are therefore shown in both
tables.
Medical aid.
The Rules of the Central Midwives Board indicate the emergencies for which
a midwife must advise in writing that medical aid be obtained, and for which such
help must be secured. A notice in the approved form is sent to the doctor, and then to
the Council. In the year now under review 6,516 such notices were received, compared
with 6,833 in 1929. The estimated number of confinements conducted by midwives
in independent practice during the year was 29,000. This appears to indicate that